Treatment of Bilateral Hand Frostbite Using Transcatheter Arterial Thrombolysis After Papaverine Infusion

Saemi, Arash M; Johnson, Jason M.; Morris, Christopher S.

doi:10.1007/s00270-009-9584-9

Cited by 35 publications

(21 citation statements)

References 7 publications

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“…A review of absolute and relative contraindications of tissue plasminogen activator (t-PA) should be undertaken. The aim of the thrombolytic treatment is to clear the occluding microvascular thromboses that accompany acute frostbite injury, and so restore arterial flow to normal [20]. The treatment should be undertaken in an HDU/ ITU setting.…”

Section: Thrombolytic Therapymentioning

confidence: 99%

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A Clinical Review of the Management of Frostbite

Davis

Dhillon

et al. 2011

J R Army Med Corps

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Frostbite is a thermal injury that can occur when temperatures drop low enough for tissue to freeze. On rewarming the tissues, an inflammatory process develops which is often associated with tissue loss. The extent of the tissue loss reflects the severity of the cold exposure and includes factors such as temperature, duration, wind chill, altitude, and systemic hypothermia. This review discusses the epidemiology, the pathophysiological processes involved, and the clinical management of frostbite injuries. Practical advice is given on both the field and hospital management and how to seek expert advice from remote situations. The review also discusses newer developments in frostbite treatment such as intra-vascular thrombolysis and adjunctive treatments such as the use of intravenous vasodilators.

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Section: Thrombolytic Therapymentioning

confidence: 99%

“…Published protocols include the use of heparin in conjunction with thrombolytic therapy to prevent recurrent local thrombosis [19,20,22].…”

Section: Heparinmentioning

confidence: 99%

A Clinical Review of the Management of Frostbite

Davis

Dhillon

et al. 2011

J R Army Med Corps

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“…Intravenous vasodilators (nitroglycerin or papaverine) are useful (in conjunction with TPA) at this stage in the treatment of the vasospasm that often accompanies a frostbite injury [17,22,23]. It is possible that non-invasive MRA may offer a suitable alternative imaging modality (Figure 2).…”

Section: Reviewmentioning

confidence: 99%

Frostbite: a practical approach to hospital management

et al. 2014

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Frostbite presentation to hospital is relatively infrequent, and the optimal management of the more severely injured patient requires a multidisciplinary integration of specialist care. Clinicians with an interest in wilderness medicine/freezing cold injury have the awareness of specific potential interventions but may lack the skill or experience to implement the knowledge. The on-call specialist clinician (vascular, general surgery, orthopaedic, plastic surgeon or interventional radiologist), who is likely to receive these patients, may have the skill and knowledge to administer potentially limb-saving intervention but may be unaware of the available treatment options for frostbite. Over the last 10 years, frostbite management has improved with clear guidelines and management protocols available for both the medically trained and winter sports enthusiasts. Many specialist surgeons are unaware that patients with severe frostbite injuries presenting within 24 h of the injury may be good candidates for treatment with either TPA or iloprost. In this review, we aim to give a brief overview of field frostbite care and a practical guide to the hospital management of frostbite with a stepwise approach to thrombolysis and prostacyclin administration for clinicians.

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“…The agent currently utilized, now that urokinase is no longer available, is tPA. Aside from well documented and routine use in the treatment of stroke and myocardial infarction, variable success has been achieved for extremity thrombotic or embolic occlusions (5)(6)(7)(8).…”

Section: If Recognized Early a Thrombectomy Can Be Performed To Restmentioning

confidence: 99%